Introduction. The prognosis for patients with bladder cancer has traditionally been determined by the disease stage according to the TNM system. However, this classification does not account for individual tumor biology characteristics such as the degree of differentiation, histological and molecular profile which are necessary for accurately predicting individual disease course and response to therapy. This underscores the need to develop additional prognostic tools. The promising way is the study of systemic inflammation markers, whose role in the progression of various malignant neoplasms has been convincingly demonstrated. However, regarding muscle-invasive bladder cancer (MIBC), the prognostic value of inflammatory indices requires clarification, and a validated model based on them is still lacking, which defines the aim of the present study.
Objective. To perform an independent external validation of a previously developed prognostic model on a test cohort of MIBC patients treated at an external medical institution.
Materials and methods. The test cohort included 39 selected patients with MIBC (T2-3N0/N+M0) hospitalized in 2018-2019 at the N.N. Petrov National Medical Research Center of Oncology for radical cystectomy (RC). The prognostic model was previously developed on a training cohort comprising 100 MIBC patients (T2-3N0/N+M0). All patients were stratified into high-risk and low-risk groups based on the values of inflammatory indices: neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR). The quality of the prognostic model was assessed using ROC analysis.
Results. All presented threshold values showed a statistically significant association with survival prognosis (p<0,05). LMR demonstrated the highest sensitivity (90.91%), while the highest specificity (70.59%) was noted for PLR. The AuROC values for all indices ranged from 0.74 to 0.77, indicating good discriminatory ability of the models.
Conclusion. Validation of the prognostic model on an independent test cohort of MIBC patients confirmed its reproducibility and good discriminatory ability. The obtained sensitivity and specificity metrics indicate the model's correct performance and its suitability for further application and extended external validation.
